Ocular abnormalities in beta thalassemia patients: prevalence, impact, and management strategies

Int Ophthalmol. 2020 Feb;40(2):511-527. doi: 10.1007/s10792-019-01189-3. Epub 2019 Oct 10.

Abstract

Background: Beta thalassemia (β-thalassemia) is a hereditary disease caused by defective globin synthesis and can be classified into three categories of minor (β-TMi), intermedia (β-TI), and major (β-TM) thalassemia. The aim of our study is to investigate the effects of β-thalassemia and its treatment methods on different parts of the eye and how early-diagnostic methods of ocular complications in this disorder would prevent further ocular complications in these patients by immediate treatment and diet change.

Methods: We developed a search strategy using a combination of the words Beta thalassemia, Ocular abnormalities, Iron overload, chelation therapy to identify all articles from PubMed, Web of Science, Scopus, and Google Scholar up to December 2018. To find more articles and to ensure that databases were thoroughly searched, the reference lists of selected articles were also reviewed.

Results: Complications such as retinopathy, crystalline lens opacification, color vision deficiency, nyctalopia, depressed visual field, reduced visual acuity, reduced contrast sensitivity, amplitude reduction in a-wave and b-wave in Electroretinography (ERG), and decrease in the Arden ratio in Electrooculography (EOG) have all been reported in β-thalassemia patients undergoing chelation therapy.

Conclusion: Ocular problems due to β-thalassemia may be a result of anemia, iron overload in the body tissue, side effects of iron chelators, and the complications of orbital bone marrow expansion.

Keywords: Beta thalassemia; Chelation therapy; Iron overload; Ocular abnormalities.

Publication types

  • Review

MeSH terms

  • Disease Management*
  • Electroretinography
  • Global Health
  • Humans
  • Prevalence
  • Retinal Diseases / epidemiology
  • Retinal Diseases / etiology*
  • Retinal Diseases / therapy
  • beta-Thalassemia / complications*